Hypoparathyroidism
Hypoparathyroidism results from reduced secretion of parathyroid hormone by the parathyroid glands. It results in hypocalcemia.
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Clinical presentation
- tetany: peripheral paresthaesia, carpopedal spasm, seizures
- emotional lability, depression and anxiety, psychosis
- short stature
Pathology
There are a number of causes of hypoparathyroidism 1:
- iatrogenic, e.g. post parathyroidectomy or thyroidectomy
- congenital absence of the parathyroid glands, which may be syndromic in thymic aplasia, or 22q11.2 deletion syndrome (a.k.a. DiGeorge syndrome)
- familial, e.g. autoimmune polyendocrine syndrome type 1
- idiopathic (probably autoimmune-mediated destruction)
Markers
- parathyroid hormone (PTH) level: low
- serum phosphate level: high
- serum calcium level: low
Radiographic features
- musculoskeletal 2,3
- focal (~25%) and generalised (~10%) osteosclerosis
- dense metaphyseal bands
- skull vault thickening 2
- diffuse idiopathic skeletal hyperostosis-like changes
- subcutaneous calcification (around shoulders and hips)
- CNS
- intracranial calcifications: most commonly basal ganglia but also subcortical white matter, corona radiata and thalamus
- head and neck
Related Radiopaedia articles
Metabolic bone disease
- bone mineralisation
- liver-related
- osteosclerosis (differential diagnosis / mnemonic)
- parathyroid-related
- pituitary gland-related
- thyroid gland-related